The Commercial Kitchens Campaign needs further examination

Why is a government workers’ compensation agency promoting first aid when a different agency has had that role for over twenty years?  And why do the program’s first aid kits contain commercial products that are no more effective in the first aid treatment of burns than water from the tap?

On May 12 2011, WorkCover SA launched, in conjunction with the Julian Burton Burns Trust, the Commercial Kitchens Campaign.  Burns are a major feature of this campaign with 500 Commercial Kitchens Burns Packs being distributed free to restaurants and cafes in South Australia.

SafetyAtWorkBlog has been told that these kits contain a Burns First Aid Kit developed by A/Prof John Greenwood, the Julian Burton Burns Trust and St John Ambulance Australia which includes the following items:

• burnaid gel
• burnaid dressing,
• a plastic sheet,
• sterile towel,
• tape, and
• step by step directions written by A/Prof John Greenwood.

The odd thing about this initiative is that medical research has shown that burnaid gels are less effective than cool running water for the first aid treatment of burns.  In the journal Wound Practice and Research (Vol 18 Number 1 – Feb 2010) Australian researchers Leila Cuttle and Roy M Kimble wrote in “First Aid treatment of burn injuries” that

“The widespread use of such dressings [Burnaid is specifically referenced] (which have now even penetrated the first aid market) is alarming considering the lack of studies which support their use.”

Cuttle & Kimble go on:

“…Burnaid has no antibacterial activity against common burn pathogens…  Studies by our group found that the application of Burnaid to deep dermal porcine burns provided no beneficial healing (in terms of duration of wound healing, histology of the scar or cosmetic appearance) compared to untreated controls.”

Another issue identified by the researchers was that

“…the viscous residue from the [hydrogel] dressing can make monitoring patients difficult when they arrive at hospital emergency, especially if a large amount of the dressing was applied.”

There was a positive (followed by another negative):

“Burnaid dressing is a very effective evaporative cooling agent (which may give it analgesic properties), however this unfortunately increases the risk of hypothermia in patients with large BSA [body surface area] burns.”

The medical research above is damning of the use of hydrogels and Burnaid in first aid treatments of burns but what do the workplace safety regulators recommend as the most appropriate first aid treatment for burns.

WorkCoverSA, a government  authority that “manages the South Australian Workers Rehabilitation and Compensation Scheme… which provides protection to workers and employers in the event of workplace injury”, supports the Commercial Kitchens Campaign.  According to the campaign’s media release the CEO of WorkCoverSA, Rob Thomson, described the campaign as:

“…aimed to minimise and prevent the incidence of workplace burn injuries in commercial kitchens and ultimately improve recovery times, ensuring workers are able to continue working.”

and that

“The campaign will help to remind all of us that as employers, workers and co-workers we have an important role to play not only in keeping workplaces safe but also, through minimising burns impact, to help keep people at work or return to work as quickly as possible.”

But the authority whose role it is to prevent injury and who advises on workplace first aid, SafeWorkSA, released an Approved Code of Practice for First Aid in the Workplace 2009 in December 2010 does not include burn gels in its standard treatment for burns.  On the issue of the use of hydrogels, it advises that they may be applicable but only in specific circumstances:

“… do not apply any lotion, ointment, gel, cream or powder – unless access to 20 minutes of clean, running water is not available, in which case use of the hydro gel in your kit may be considered” [SafeWorkSA’s emphases]

The nature of first aid treatment is to provide immediate relief or control of an injury and seek further medical assistance.  In many urban areas of Australia, emergency ambulances have an average response time of less than ten minutes (NSW), eleven minutes (VIC), fifteen minutes (WA), or 15.6 minutes (SA).  Emergency medical assistance is most likely to occur within the time of the standard treatment of burns rendering the application of hydrogels, like Burnaid, unnecessary.

Burnaid and the standard treatment of burns seems to be organisationally compatible from the information above but the Commercial Kitchens Campaign is unnecessarily confusing the community on first aid.  It is unclear whether any of the kits’ first aid information recommends the standard first aid treatment for burns (as illustrated simply in this St John Ambulance factsheet).

The endorsements and sponsorship of the Commercial Kitchens Campaign indicate a level of authority on the issue of first aid but the community has difficultly distinguishing between Workcovers and WorkSafes.  More appropriate OHS authority in this campaign could have come from a SafeWorkSA executive.

The campaign should also have distinguished between first aid treatment and long-term burns treatment.  The kit contents blur the very different treatment options and may be, in the longer term, increasing business costs on first aid equipment unnecessarily.

The reference to St John Ambulance in the campaign material also requires some clarification.  It seems that St John Ambulance has developed a burns first aid kit that includes components that are contrary to its own standard first aid treatment for burns.

The Commercial Kitchens Campaign needs closer examination in the context of workplace safety management and the prevention of injuries.  A complementary emphasis in this campaign could have been the prevention of burns rather than the treatment of burns.  WorkSafe Victoria, as part of its injury hotspots program provided the following recommendations for preventing burns in fast food restaurants:

• “Place splatter guards around deep fryers.
• Ensure that workers near flames or splattering oil wear long-sleeved fire-resistant shirts, aprons and gloves.
• When removing fried foods from deep fryers, allow the grease to drain for several seconds.”

If these, and other controls, were followed in commercial kitchens the need for any burns first aid kit would be greatly reduced.

Kevin Jones